This case involves a 60 year old male patient with a past medical history of diabetes, heart disease, and kidney disease. He was being seen by a dermatologist for itchy, bleeding lesions affecting both temples and upper cheeks for a one month duration. These lesions were described to be excoriated plaques and the working diagnosis was that of neurodermatitis. Lidex was prescribed twice daily at this point with a followup in three weeks. Upon followup, the condition was improving somewhat but the lesions were still present which prompted the physician to perform a biopsy. The patient was started on ultraviolet light (UVB) room treatment for 1.5 minutes with 30 second increases, every week as tolerated. After several months of treatment the patient complained of a red and painful burning sensation on his face which was described by the physician as a possible photo-derm reaction.
Question(s) For Expert Witness
- Are you familiar with a case such as this and can you speak on the protocol involved in using UVB light for the treatment of skin disorders and also what complications are considered to be beyond that of common occurrences? Also should the physician have noticed the reaction and stopped the successive light therapy sessions?